Provider Demographics
NPI:1902941818
Name:PARKER DRUG COMPANY
Entity Type:Organization
Organization Name:PARKER DRUG COMPANY
Other - Org Name:PARKER DRUG COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-635-0011
Mailing Address - Street 1:113 NW CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:NC
Mailing Address - Zip Code:28365-1718
Mailing Address - Country:US
Mailing Address - Phone:919-635-0011
Mailing Address - Fax:919-635-1311
Practice Address - Street 1:113 NW CENTER ST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365-1718
Practice Address - Country:US
Practice Address - Phone:919-635-0011
Practice Address - Fax:919-635-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NC82543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0965656Medicaid
2069515OtherPK
2069515OtherPK